The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Nov 2013
Randomized Controlled Trial Clinical TrialPredictors of response to tiotropium versus salmeterol in asthmatic adults.
Tiotropium has activity as an asthma controller. However, predictors of a positive response to tiotropium have not been described. ⋯ Although these results require confirmation, predictors of a positive clinical response to tiotropium include a positive response to albuterol and airway obstruction, factors that could help identify appropriate patients for this therapy.
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J. Allergy Clin. Immunol. · Nov 2013
Rhinovirus infection causes steroid resistance in airway epithelium through nuclear factor κB and c-Jun N-terminal kinase activation.
Although inhaled glucocorticoids are the mainstays of asthma treatment, they are poorly effective at treating and preventing virus-induced asthma exacerbations. The major viruses precipitating asthma exacerbations are rhinoviruses. ⋯ RV-16 infection of human airway epithelium induces glucocorticoid resistance. Inhibition of RV-16-induced JNK and nuclear factor κB activation fully reversed rhinovirus impairment of both GRα nuclear translocation and the transactivation/transrepression activities of glucocorticoids.
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J. Allergy Clin. Immunol. · Nov 2013
Comparison of phenotypes of childhood wheeze and cough in 2 independent cohorts.
Among children with wheeze and recurrent cough there is great variation in clinical presentation and time course of the disease. We previously distinguished 5 phenotypes of wheeze and cough in early childhood by applying latent class analysis to longitudinal data from a population-based cohort (original cohort). ⋯ Applying the same method to 2 different cohorts, we consistently identified 2 phenotypes of wheeze (atopic persistent wheeze, transient viral wheeze), suggesting that these represent distinct disease processes. Differences found in other phenotypes suggest that the age when features are assessed is critical and should be considered carefully when defining phenotypes.
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J. Allergy Clin. Immunol. · Nov 2013
Anaphylaxis: clinical patterns, mediator release, and severity.
Prospective human studies of anaphylaxis and its mechanisms have been limited, with few severe cases or examining only 1 or 2 mediators. ⋯ The results suggest that multiple inflammatory pathways drive reaction severity and support recommendations for safe observation periods after initial treatment.
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J. Allergy Clin. Immunol. · Nov 2013
Randomized Controlled Trial Multicenter StudyEffects of benralizumab on airway eosinophils in asthmatic patients with sputum eosinophilia.
Many asthmatic patients exhibit sputum eosinophilia associated with exacerbations. Benralizumab targets eosinophils by binding IL-5 receptor α, inducing apoptosis through antibody-dependent cell-mediated cytotoxicity. ⋯ Single-dose intravenous and multiple-dose subcutaneous benralizumab reduced eosinophil counts in airway mucosa/submucosa and sputum and suppressed eosinophil counts in bone marrow and peripheral blood. The safety profile supports further development. Additional studies are needed to assess the clinical benefit in asthmatic patients.